Kornimate/medical-research-clean huggingface dataset:
acupuncture for chronic pain

Conditions: Chronic Pain

Summary: chronic pain is a significant public health problem, associated with impairments of physical and psychological functioning. while a third or more of the general population may suffer from chronic pain, it is often under recognized and under treated in health care settings. low income and minority samples experience disparities in the prevalence of chronic pain, in perceived access to effective pain treatment, and in consultations for pain. a great deal of literature suggests that acupuncture offers potential benefit in the management of chronic pain, but it is rarely available to low income patients. the acupuncture to decrease disparities in outcomes of pain treatment (addopt) project will introduce and evaluate the addition of acupuncture to the management of chronic pain for ethnically diverse, low-income primary care patients. the project represents a collaboration between the new york city research and improvement networking group (nyc ring), a practice-based research network dedicated to decreasing health disparities through primary care research, the continuum center for health and healing,the swedish institute school of acupuncture, and pacific college of oriental medicine. our intervention will involve addition of weekly acupuncture sessions at 3 urban primary care practices. during training sessions at each practice, primary care providers will become familiar with acupuncture and indications for referral. patients will be eligible if they experience chronic pain due to neck pain, back pain, or osteoarthritis. our process evaluation, guided by glasgow's reaim framework, will assess barriers to implementation and adoption of the intervention in busy urban practices and acceptability to patients and providers. the investigators will employ a quasiexperimental design to assess primary outcomes (pain and quality of life) and obtain preliminary estimates of secondary outcomes (health care utilization and costs) of the intervention at each health center. this design will permit comparison across sites to discern practice level differences in uptake and outcomes.


Eligibility criteria:
inclusion criteria: * chronic pain due to osteoarthritis, back pain or neck pain; english or spanish speaking exclusion criteria: * active substance abuse; cognitive impairment; coumadin therapy

Keywords: acupuncture health services research chronic pain health disparities
low exhaled no and ics in suspected asthma

Conditions: Asthma

Summary: the purpose of this study is to determine whether a low exhaled nitric oxide reading (\<27ppb) is a good predictor of a negative response to inhaled steroid treatment for patients with symptoms suggestive of asthma.

at the first visit, which will take place at either at the gp surgery or the nottingham respiratory research unit (nrru) informed written consent for the study will be obtained. the patients will then have an exhaled no measurement, spirometry, venepuncture (for full blood count and research blood - if consent obtained) taken and complete an asthma control questionnaire (acq), medical research council dyspnoea scale (mrc) and leicester cough questionnaire (lcq). all procedures will be carried out by the nrru research nurse. the investigators may use the nrru existing database of research volunteers to recruit as necessary and also the respiratory clinics held at the nuh. if patients from clinics are recruited they will be initially approached by their usual care doctor and an information sheet will be sent / given to them accordingly. if all the inclusion criteria are met and none of the exclusion criteria, the patients will be randomised to receive either a placebo inhaler, to be taken one puff twice daily, or a low dose inhaled steroid treatment, budesonide 200mcgs via turbuhaler one puff twice daily, for 3 months. dr tim harrison will be prescribing the inhalers and they will be dispensed from the nottingham city hospital clinical trials pharmacy and delivered/given to the patient by the research nurses. participants will be asked to return for follow up visits at 4 weeks, 8 weeks and 12 weeks following randomisation. at these follow up visits, exhaled no, spirometry and the 3 questionnaires will be repeated.

Eligibility criteria:
inclusion criteria: 1. aged 18 years or over. 2. asthma suspected by gp/practice nurse 3. must be able to give informed consent 4. exhaled nitric oxide reading \<27ppb 5. fev1 \>70% predicted exclusion criteria: 1. patients requiring oral steroid treatment on visit to gp/practice nurse 2. use of oral prednisolone or antibiotics within last 4 weeks 3. already using an inhaled corticosteroid 4. any other clinically significant co-morbidity. 5. expectant or breast feeding mothers.
upper vaginectomy versus brachytherapy in patients with early stage endometrial cancer treated with laparoscopic surgery

Conditions: Early Stage Endometrial Cancer

Summary: recent findings have suggested that laparoscopic surgery is safe and effective, as well as laparotomic one, for treating patients with early stage endometrial cancer (esec). moreover, our long-term previous data have shown a trend in vaginal cuff recurrence in subjects who underwent laparoscopic approach to esec consisting of extrafascial hysterectomy, bilateral salpingo-oophorectomy, pelvic +/- para-aortic nodes dissections, regardless grading or lymphovascular space invasion. based on these considerations, the aim of the current protocol-study will be to compare two different strategies for vaginal cuff recurrences prevention in patients affected by esec treated with laparoscopic surgery. in particular, upper vaginectomy followed by observation will be compared to post-operative brachytherapy.

women with esec scheduled for laparoscopic surgery will be enrolled and randomized in three arms \[vaginectomy group (vg), brachytherapy group (bg), and control group (cg)\]. all laparoscopic procedures will consist of total hysterectomy, bilateral salpingo-oophorectomy, peritoneal washing, systematic inspection of peritoneal cavity and biopsy of each suspect lesion, and pelvic (and eventual para-aortic) lymphadenectomy. in vg an upper vaginecomy will be added to standard laparoscopic procedures followed by observation, whereas bg will receive post-operative brachytherapy. cg will be treated with standard protocol for management of esec according to national comprehensive cancer network (www.nccn.org). safety and efficacy data will be recorded in each group for 24 months of follow-up. data will be analyzed using the intention-to-treat principle and a p value of 0.05 or less will be considered significant.

Eligibility criteria:
inclusion criteria: * early stage endometrial cancer exclusion criteria: * other pre-malignancies and malignancies * major medical conditions * psychiatric disorders * current or past history of acute or chronic physical illness * premenstrual syndrome (pms) * current or past (within 6 months from study enrolment) use of drugs influencing cognition, vigilance, and/or mood.

Keywords: brachytherapy early stage edometrial cancer quality of life recurrence treatment vaginectomy
the hemodynamic effects of cgrp after glibenclamide administration in healthy volunteers

Conditions: Hemodynamics of Cranial Arteries; Headache; Cerebral Blood Flow

Summary: to investigate the hemodynamic effects of cgrp after glibenclamide administration.

20 healthy participants will randomly be allocated to receive cgrp infusion followed by glibenclamide or placebo on two different days. the aim of the study is to investigate the vascular effect of cgrp after glibenclamide administration. repeated measurements covering the arteria radialis (ra), superficiel temporal artery (sta) and middle cerebral artery (mca) before and after glibenclamide/placebo administration and cgrp infusion.

Eligibility criteria:
inclusion criteria: * healthy volunteers of both sexes. * 18-60 years. * 50-100 kg. * women of childbearing potential must use adequate contraception exclusion criteria: * a history of serious somatic disease * migraine or any other type of headache (except episodic tension-type headache less than once a month) * daily intake of any medication except contraceptives
clonidine as adjunct to morphine for neonatal abstinence syndrome

Conditions: Neonatal Abstinence Syndrome

Summary: this is a prospective randomized double blinded study comparing the effect on duration of pharmacologic treatment and duration of hospital stay when using clonidine at 12 µg/kilogram/day as an adjunct to oral morphine as compared to morphine monotherapy in the management of term and near term infants with neonatal abstinence syndrome (nas)

neonatal abstinence syndrome (nas) is an emerging epidemic and has lead to a tremendous increase in cost of medical care. opioids are the mainstay of treatment for nas although there are concerns about possible short-term and long-term effects including but not limited to adverse neurodevelopmental outcomes. other drugs such as clonidine, phenobarbitone, methadone and buprenorphine have been evaluated to limit the postnatal exposure to opioids in these infants. clonidine is an alpha 2 receptor and can lessen withdrawal manifestations. the addition of clonidine at 6 µg/kilogram/day to morphine in the management of nas has been shown to reduce the duration of pharmacotherapy by about 27% in a previous study. a recent pilot study reported reduction of treatment duration for nas with clonidine (12 µg/kilogram/day) monotherapy as compared to morphine monotherapy. the study reported no adverse effects in study subjects at the doses used in the study. the investigators hypothesize that there will be a minimum of 30% reduction in the treatment duration with 12 µg/kilogram/day clonidine used as adjuncts to standard morphine treatment as compared to morphine monotherapy in the management of term and near term infants with nas

Eligibility criteria:
inclusion criteria: * requiring neonatal intensive care unit (nicu) admission for management of neonatal abstinence syndrome * gestational age greater than or equal to 36 weeks * less than or equal to 48 hours of treatment with morphine for nas exclusion criteria: * presence of seizures * congenital malformations, genetic syndromes or the presence of torch infections * major medical problems * heart rate and/or blood pressure instability
first-in-human (fih) study of w0180 as single agent and in combination with pembrolizumab in adults with locally advanced or metastatic solid tumors

Conditions: Locally Advanced or Metastatic Solid Tumors

Summary: the purpose of this study will be to determine the maximum tolerated dose (mtd) and describe dose-limiting toxicities (dlts) of w0180 given as monotherapy and in combination with pembrolizumab (anti-pd-1).


Eligibility criteria:
inclusion criteria: * histologically or cytologically confirmed diagnosis of locally advanced or metastatic solid tumors, whose disease has progressed or for whom no further standard therapy is available or appropriate * evidence of measurable disease as determined by response evaluation criteria in solid tumors (recist) version 1.1 (or modified recist 1.1 for mesothelioma) * adequate blood counts at baseline * adequate liver function at screening and baseline * sexually active participants must use medically acceptable methods of contraception during the course of this study exclusion criteria: * participants previously treated with an anti-v-domain ig suppressor of t cell activation (vista) (small molecule or antibody) agent * participants with known central nervous system (cns) metastases and/or carcinomatous meningitis * history of severe hypersensitivity reactions to other monoclonal antibodies * positive for hepatitis b virus(hbv), hepatitis c virus (hcv) or hiv infection * history of anti-cancer therapies within the last 4 weeks (or \<=5 half-lives for targeted agents) prior to initiating study treatment.

Keywords: advanced cancer w0180
diagnostic accuracy of ccta-derived versus angiography-derived quantitative flow ratio (career) study

Conditions: Coronary Stenosis; Hemodynamics; Coronary Artery Disease; Coronary Computed Tomography Angiography

Summary: to perform ct-qfr, invasive coronary angiography, ffr, and qfr tests on patients with moderate coronary stenosis after coronary cta examination. use ffr as a reference to verify the diagnostic performance of ct-qfr, and compare it with qfr.

this study is a prospective and single-center trial in china.it intends to enroll 216 patients with coronary artery disease whose coronary artery is determined to be 30-90% stenosis after coronary ct scan. ct image data will be imported for ct-qfr detection and undergo coronary angiography within 30 days. quantitative analysis of coronary angiography (qca) was performed with the degree of coronary stenosis. ffr and qfr were detected during the operation. use ffr as a reference standard to verify the diagnostic performance of ct-qfr and qfr. the primary endpoint is the diagnostic accuracy of ct-qfr in identifying hemodynamically significant coronary stenosis with ffr as the reference standard. major secondary endpoint is the non-inferiority of ct-qfr compared with qfr in the patients without extensively calcified lesions. the completion of the project will provide patients with a practical non-invasive assessment method of coronary heart disease which provides the best treatment strategy.

Eligibility criteria:
inclusion criteria: 1. coronary ct angiography indicates that \>= 1 stenosis with percent diameter stenosis between 30%-90% in a vessel \>= 2mm. 2. the invasive coronary angiography should be less than 30 days after the coronary ct angiography. exclusion criteria: 1. the target lesion has received coronary stent implantation or coronary artery bypass graft. 2. target lesion involves myocardial bridge. 3. severe heart failure (nyha ≥iii). 4. renal function is seriously damaged (egfr\<30 ml/min/1.73m2). 5. those who are contraindicated to use contrast agents, beta blockers, nitrates or adenosine drugs. 6. acute myocardial infarction within 1 month. 7. the image quality of cta or coronary angiography cannot be assessed. 8. any factors that affect the image quality of coronary cta and coronary angiography, such as frequent premature contractions, atrial fibrillation, etc.

Keywords: coronary stenosis coronary computed tomography angiography hemodynamics ct-qfr qfr
music listening as a postanesthesia care unit (pacu) nursing intervention

Conditions: Prostate Cancer

Summary: a randomized comparison clinical trial will be conducted in laparoscopic radical prostatectomy patients in the weinberg pacu at the johns hopkins hospital. 50 patients will be recruited and randomly assigned by a table of random numbers to either the music listening group (n=35) or the relaxation breathing group (n=35).

hypothesis: laparoscopic radical prostatectomy patients who experience music listening will report decreased anxiety scores and improved pain control scores compared with patients listening to relaxation and breathing. null hypothesis: there will be no difference in reported anxiety scores and pain control scores between laparoscopic radical prostatectomy patients listening to music versus listening to relaxation and breathing instructions. music listening participants who meet inclusion criteria will be consented in the preop unit and asked to complete the spielberg state trait anxiety inventory (stai) questionnaire. patient vital signs will be taken and patient will be invited to listen to music study ipod for 15 minutes prior to changing into a hospital gown. intervention: the music listening group will receive the standard care and a 15 minute patient-preferred music listening selection intervention in the prep room and unlimited music listening selection intervention in the pacu once cognitively ready until discharge criteria met. the relaxation breathing group will receive the relaxation and breathing instructions over soft monotone music in the pacu once cognitively ready until discharge criteria met. results: the experimental music listening group will reveal statistically significant decrease postanesthesia anxiety and pain, while lowering the blood pressure, heart rate and amount of opioids after laparoscopic radical prostatectomy surgery compared to the control group. conclusion: the findings of the music listening intervention will provide further evidence to support the practice of music listening to decrease postanesthesia anxiety and pain, while lowering the blood pressure, heart rate and amount of opioids after laparoscopic radical prostatectomy surgery.

Eligibility criteria:
inclusion criteria * all adult male patients schedule to have a laparoscopic radical prostatectomy surgery who are ages 45 to 80 years of age * all ethnic backgrounds * all religions exclusion criteria: * all patients who do not speak or understand the english language to the extent that it precludes their ability to provide informed consent for the study

Keywords: music listening prostate cancer anxiety pain management postoperative
evaluating disparities in precision oncology

Conditions: Metastatic Cancer; Advanced Cancer

Summary: this is a non-randomized observational trial designed to collect detailed clinical, social determinant, and genomic data from patients enrolled in molecular oncology tumor boards across four comprehensive cancer centers.

this study proposes an innovative approach leveraging the molecular tumor boards across four comprehensive cancer centers, where real- world, diverse patients with metastatic cancer are seen receiving a broad scope of therapies in the context of precision medicine. the study plans to collect detailed clinical, social, and genomic data from patients to identify significant contributors of disparate survival and toxicity outcomes for patients with metastatic cancer.

Eligibility criteria:
inclusion criteria: 1. ability to provide written informed consent and hipaa authorization 2. patients must be ≥ 18 years old at the time of consent 3. patients planning to undergo molecular testing as part of their routine cancer care exclusion criteria: n/a

Keywords: precision medicine disparities
peg-rhg-csf in patients with non-hodgkin lymphoma receiving chemotherapy to prevent neutropenia

Conditions: Lymphoma,Non-Hodgkin

Summary: neutropenia is one of the most frequent adverse effects of chemotherapy, and the main factor to limit the dosage and the continuation of chemotherapy. the peg-rhg-csf has increased plasma half-life, and prolonged efficacy in compare with rhg-csf. the purpose of this study is to determine the safety and effectiveness of peg-rhg-csf in preventing neutropenia following chemotherapy in patients with non-hodgkin lymphoma.

neutropenia is a common clinical complication of chemotherapy in cancer patients. it is an important factor that delays the course of standard treatments in patients. recombinant human granulocyte colony-stimulating factor (rhg-csf) is an effective drug for the treatment of chemotherapy-induced neutropenia. however, for patients with neutropenia, multiple rhg-csf treatments are usually required. this is likely to extend the antitumor treatment period and increase physical and mental stress in patients. pegylated recombinant human granulocyte colony-stimulating factor (peg-rhg-csf) is rhg-csf chemically modified by a single methoxy polyethylene glycol group; it is able to alleviate neutropenia with a single dose. the aim of the present study was to determine the safety and effectiveness of preventive treatment with pegylated recombinant human granulocyte colony stimulating factor (peg-rhg-csf) on concurrent chemotherapy-induced neutropenia and to provide a rational basis for its clinical application. therefore, the investigators designed the multi-center, open-label,randomized controlled clinical study and aimed to compare the efficacy and safety between peg-rhg-csf and rhg-csf in non-hodgkin lymphoma receiving chemotherapy.

Eligibility criteria:
inclusion criteria: * investigator diagnosis of non-hodgkin lymphoma(highly invasive lymphoma/burkitt lymphoma were excluded) * age 18 to 80 years * ecog performance status ≤ 2 * receive multi-cycle chemotherapy naive * grade 3/4 neutropenia occurred in the patient's first cycle chemotherapy or the risk of neutropenia \>20% without rhg-csf support * expected survival time≥3 months; cnormal bone marrow function(absolute neutrophil count ≥1.5 × 109/l; platelet count ≥ 80 × 109/l) * liver function: transaminase≤2.5× upper limit of normal value，bilirubin≤2.5×upper limit of normal value; serum creatinine≤2×upper limit of normal value; exclusion criteria: * patients with severe complications or severe infection; * invasion of central nervous system; * patients with severe visceral organ dysfunction, heart block, myocardial infarction within 6 months; * prior bone marrow stem cell or organ transplantation * patients with severe allergic constitution, or those who are allergic to escherichia coli products; 5. patients participate in other clinical studies within 4 weeks; * pregnancy, lactation * other patients who are not suitable for the study.

Keywords: lymphomas non-hodgkin's b-cell lymphomas non-hodgkin's t-cell peg-rhg-csf neutropenia
aesculus hippocastanum l. on fontan circulation

Conditions: Univentricular Heart

Summary: patients after the fontan operation at a single institution will be randomized to receive a standardized extract of aesculus hippocastanum l. (horse chestnut) or placebo for 4 months in a crossover clinical trial. the primary outcome will be the mesenteric artery resistance measured by dopple sonography.


Eligibility criteria:
inclusion criteria: * underwent fontan surgery exclusion criteria: * severe adverse reaction * personal or parental request

Keywords: fontan operation aesculus hippocastanum mesenteric artery resistance
effect of telemedecine on post -trauma pain medication adherence .

Conditions: Post-traumatic Pain

Summary: the impact of telemonitoring on patients' adherence to post trauma pain treatment , their satisfaction and pain relief after discharge from the ed.

this is a prospective, multicenter, randomized trial . participants are recruited from the emergency departement of fattouma bourguiba monastir. this study is a seven day three-arm parallel group trial . participants inculded are aged more than 16 years old who presented to the ed for minor trauma and discharged with analgesic treatment. they are randomized to one of two trial tm intervention groups (sms and tm) or usual care group (control) in a 1 :1 :1 allocation ratio. for all inculded patients, demographic characteristics were collected as well as clinical examination findings. the interventional care provided at the ed was mentioned. at ed discharge the pain visual analogue scale (vas) was evaluated and the analgesic treatment prescribed was noted.

Eligibility criteria:
inclusion criteria: * age \>16 years old with minor trauma and discharged with an analgesic treatment. * included patients should have regular access to a mobile phone ,were able to interact with sms or could do so with help of a relative. * patients who accepted to participate to the study. * no contraindication to analgesic medication exclusion criteria: * swallowing disorder or inability to swallow. * unsuitable for follow-up.

Keywords: telemedecine adherence post- traumatic pain